The effect of thiazide therapy on glucose, insulin and cholesterol metabolism and of glucose on potassium: results of a cross-sectional study in patients from the Hypertension Detection and Follow-up Program.
Fasting and one hour post-glucose load blood samples were obtained from 497 participants in the Hypertension Detection and Follow-up Program (HDFP), 79.8% of whom were on antihypertensive therapy at the time of their five-year examination. Major findings include a positive correlation between glucose/insulin ratio and serum potassium (P = 0.0014) and a weaker negative correlation between fasting insulin and serum potassium (P = 0.004). These data are compatible with a primary effect of hypokalaemia producing insulin 'resistance'. In addition, the glucose load was followed by a mean reduction in serum potassium of 0.135 +/- 0.525 meq/l (P less than 0.001). Twenty percent of participants experienced a drop of more than 0.5 meq/l. Cholesterol was associated with the fasting glucose/insulin ratio (P less than 0.032). The results are compatible with the hypothesis that prevention of hypokalaemia may prevent certain metabolic effects attributed to thiazide.
Langford
H G
HG
Department of Medicine, University of Mississippi Medical Center, Jackson 39216-5405.
Cutter
G
G
Oberman
A
A
Kansal
P
P
Russell
G
G
D000328:Adult; D000368:Aged; D001581:Benzothiadiazines; D002784:Cholesterol / Q000378:metabolism*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004232:Diuretics; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism* / Q000494:pharmacology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D007008:Hypokalemia / Q000517:prevention & control; D007328:Insulin / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood*; D049993:Sodium Chloride Symporter Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*
D001581:Benzothiadiazines; D004232:Diuretics; D007328:Insulin; D049993:Sodium Chloride Symporter Inhibitors; D002784:Cholesterol; D005947:Glucose; D011188:Potassium